University of California, San Diego Health System is one of only a few hospitals in the nation to offer computer-assisted navigation technology with the direct anterior hip replacement technique, potentially resulting in less pain, faster recovery and fewer dislocations for patients with osteoarthritis and other forms of degenerative joint disease.
Only 15 percent of the top joint centers in the United States have the expertise and technological capability to perform an anterior hip replacement, where the incision is made in the front (anterior) of the hip as opposed to the side (lateral) or back (posterior). The anterior approach allows the surgeon to work in between a natural muscle plane without detaching muscles or tendons from the hip or thigh bone, avoiding undue trauma to the muscle and surrounding tissue.
“With traditional hip replacements, we have to cut muscle to do the surgery, which affects the recovery process and may limit immediate hip movement in the early post-operative period,” said Francis Gonzales, MD, orthopedic surgeon specializing in adult joint reconstruction at UC San Diego Health System. “The muscle-sparing approach is performed in between muscle groups, gently pushing the muscle aside during the hip replacement instead of cutting through it.”
UC San Diego Health System performs a high volume of anterior hip replacements annually, making it a leader in the region on the technique.
Gonzales, who is fellowship-trained in anterior hip replacements, is the only surgeon in San Diego performing the technique using computer-assisted navigation on a specialized surgical table from Mizuh OSI, which allows for live imaging guidance and manipulation in real time to confirm the hip replacement implants are precisely placed.
“The specialized surgical table used during an anterior hip replacement is a vital instrument used during the procedure. It enables the surgeon to perform the surgery with ease and decreases the complication rate,” said Gonzales. “The table allows for safe leg placement not possible with a traditional surgery table.”
The anterior hip replacement approach means faster recovery, no limitations with hip movement, and increased stability with potentially fewer dislocations for the patient.
Most patients are candidates for the anterior hip replacement. Previous surgery, revision surgery or certain deformities may make an anterior approach not feasible. Gonzales said his team sees a significant difference in the first year of recovery in patients who receive an anterior hip replacement.
“Shortly after surgery, patients are back to their active lifestyles and hobbies they are passionate about,” said Gonzales, who is a leading authority on anterior hip replacement and trains other surgeons nationally on the technique. “The results of this approach motivate our team to continue exploring new, leading edge techniques that will enhance the overall patient experience with joint replacements.”
The specialty trained orthopedic surgeons and nonsurgical sports medicine specialists at UC San Diego Health System are on the cutting edge of innovation, with access to the latest technological advances, diagnostic techniques and treatment strategies. UC San Diego Sports Medicine specialists include primary care physicians, specializing in sports medicine, as well as orthopedic surgeons trained in advanced, minimally-invasive surgical techniques. Patients benefit from a multi-disciplinary team approach geared toward making the correct diagnosis, treating the injury and identifying and minimizing underlying causative factors.